Lowrycrosby9988
The objective of this study is to evaluate smell and taste dysfunction (STD) in coronavirus disease 2019 (COVID-19) positive and negative patients, and to assess the factors associated with STD in COVID-19 positive patients.
Patients who had been tested with the real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for COVID-19 were identified, and according to the RT-PCR test results, patients were separated into Positive and Negative Groups. A telephone-based assessment was applied to both groups using the American Academy of Otolaryngology-Head and Neck Surgery Anosmia Reporting Tool. Patients in Positive Group were also asked to rate STD, nasal breathing, and anxiety in three different time periods (pre-/during-/post-COVID) using the visual analog scale (VAS).
A total of 53 COVID-19 positive and 51 negative patients completed the surveys. STD was eightfold more frequent (OR 8.19; CI 95% 3.22-20.84) inthePositive Group. Of the 53COVID-19 positivepatients, 32 reported STD and 21 did not. 'Ground-glass appearance' onchest-computedtomography was more frequent and median lymphocyte count was significantly lower inCOVID-19 positivepatients with STD. During-COVID STD and nasal breathing VAS scores were significantly lower than the pre- and post-COVID scores. During-COVID STD scores were significantly correlated with anxiety scores (Spearman's rho-0.404, p = 0.022) but not correlated withnasal breathing scores.
STD may be related to increased inflammatory response as well as damage of olfactory neuronal pathway or non-neuronal olfactory mucosa. Understanding the exact cause of chemosensory impairment in COVID-19 can be helpful in explaining the pathophysiology of the disease.
STD may be related to increased inflammatory response as well as damage of olfactory neuronal pathway or non-neuronal olfactory mucosa. Understanding the exact cause of chemosensory impairment in COVID-19 can be helpful in explaining the pathophysiology of the disease.
The aim of this study was to determine the prevalence and effect of adherence to intensive nutritional care on nutritional outcomes and survival in head and neck cancer patients undergoing radiotherapy.
Three-hundred and seventeen head and neck cancer patients referred to intensive nutrition support during radiotherapy were retrospectively analyzed. Patients who missed less than 25% of their appointments with the dietitian were considered adherent. Primary outcome was percentage weight loss during treatment. Secondary outcomes were overall survival and patients' capacity to accomplish their caloric and protein recommendations. Logistic regression was used to examine predictors of weight loss and Kaplan-Meier to estimate survival.
Less than half of the patients (n = 145, 45.7%) were adherent. Statistically significant less weight loss in the adherent group (42.8% vs 55.8%; p = 0.02) was found, despite no difference in energy or protein intake. Logistic regression models after adjusting for other variables demonstrated that adherence resulted in 43% protection from significant weight loss (odds ratio 0.57, 95% CI 0.34-0.97). Overall survival was not different between groups.
Findings demonstrated that patients who were adherent to weekly contacts with the dietitian had less weight loss, but not better survival or nutritional intake. Additional investigation of factors that may act as barriers or enablers for adherence could help improve the outcomes in this population.
Findings demonstrated that patients who were adherent to weekly contacts with the dietitian had less weight loss, but not better survival or nutritional intake. Additional investigation of factors that may act as barriers or enablers for adherence could help improve the outcomes in this population.
To report on failures related to active middle ear implants (AMEI) surgery, within a series of subjects treated at a single Implanting Center.
A retrospective review of 79 cases of implanted AMEI has been performed to report the failure ratio, the causes for the failure and the selected rehabilitative solution. The AMEI included 25 Vibrant Soundbridge
(Medel, Innsbruck, Austria), 20 as round window vibroplasty (RW-VSB) for mixed hearing loss, 5 as incus-vibroplasty for sensorineural hearing loss; 7 MET/Carina
(Cochlear, Melbourne, Australia), 2 MET for mixed and sensorineural hearing loss, 5 Carina for sensorineural hearing loss; 43 Esteem
(EnvoyMedical, St Paul, USA) for sensorineural hearing loss; 3 Maxum
(Ototronics, Texas, USA) for sensorineural hearing loss; 1 Codacs
(Cochlear, Melbourne, Australia) for severe mixed hearing loss.
The overall complication rate affected 20% of the implanted devices, individually ranging from 6.9 to 100%. Hardware system failures were recorded in all the AMEI, ranging from 10 to 50%. The alternative auditory rehabilitation included replacement of the same system in 2 cases, use of a conventional hearing aid in 3 cases, Cochlear implantation in 4 cases and implantation in the contralateral ear in 2 cases.
The present clinical experience showed that, in spite of the successful functional rate displayed by the majority of the AMEI implantees, complications may occur to a certain percentage of cases and should prompt the professionals to select alternative solutions, starting from the (re)adoption of a conventional hearing aid and ending up to Cochlear implantation.
The present clinical experience showed that, in spite of the successful functional rate displayed by the majority of the AMEI implantees, complications may occur to a certain percentage of cases and should prompt the professionals to select alternative solutions, starting from the (re)adoption of a conventional hearing aid and ending up to Cochlear implantation.
Around 20% of patients hospitalized for COVID-19 need mechanical ventilation (MV). MV may be prolonged, thus warranting tracheostomy.
Observational cohort study enrolling patients admitted due to COVID-19. Demographic and clinical data at hospital and ICU admission were collected. VX-702 molecular weight The primary endpoint was to identify parameters associated with a need for tracheostomy; secondary endpoints were to analyze the clinical course of patients who needed tracheostomy.
118 patients were enrolled; 37 patients (31.5%) were transferred to ICU, of which 11 (29.72%) needed a tracheostomy due to prolonged MV. Sequential Organ Failure Assessment (SOFA) score at ICU admission (OR 0.65, 95% CI 0.47-0.92, p 0.015) was the only variable found to be associated with increased risk of the need for tracheostomy, with a cut-off point of 4.5 (sensitivity 0.72, specificity 0.73, positive predictive value 0.57 and negative predictive value 0.85). The main complications were nosocomial infection (100%), supraventricular cardiac arrhythmia (45.5%), agitation (54.5%), pulmonary thromboembolism (9.1%) and depression (9.1%). All patients presented with hypoalbuminemia and significant critical illness polyneuropathy.
SOFA at ICU admission is associated with an increased risk of tracheostomy in patients with COVID-19. Moreover, they present clinical features similar to those with chronic critical illness and suffer SARS-CoV-2-related complications.
SOFA at ICU admission is associated with an increased risk of tracheostomy in patients with COVID-19. Moreover, they present clinical features similar to those with chronic critical illness and suffer SARS-CoV-2-related complications.
To evaluate tinnitus and its management in patients with vestibular schwannoma (VS) who underwent surgery, we investigate the effect of surgical approach or residual hearing on tinnitus severity and the effects of intervention for tinnitus including educational counseling, sound therapy using hearing aids (HAs), and medication (selective serotonin reuptake inhibitors, and SSRIs).
Seventy-one subjects of VS patients who underwent surgery were included. Their tinnitus severity was evaluated using the Japanese version of the Tinnitus Handicap Inventory (THI). The relationships between postoperative THI scores and surgery types or residual hearing levels were examined. We also examined longitudinal changes in THI scores and the efficacy of the intervention.
Surgery approach, hearing preservation or hearing loss surgery, and residual hearing levels were not significantly related to the postoperative tinnitus severity. In 71 cases, 45 cases did not require any management for tinnitus. On the contrary, 26 patients had at least one episode of tinnitus distress (THI score was greater than or equal to 18). Educational counseling alone was found to be effective in 17 cases out of the 26 cases, and the remaining 9 cases required more intervention than educational counseling alone. We selected sound therapy with HA for 7 cases and administration of SSRI for 2 cases, which was found to be highly effective in 8 cases.
Based on the present study, we consider that appropriate management may be possible for tinnitus in the majority of VS patients who underwent surgery.
Based on the present study, we consider that appropriate management may be possible for tinnitus in the majority of VS patients who underwent surgery.This study reports on the fabrication of biocompatible organic devices by means of inkjet printing with a novel combination of materials. The devices were fabricated on Parylene C (PaC), a biocompatible and flexible polymer substrate. The contact tracks were inkjet-printed using a silver nanoparticle ink, while the active sites were inkjet-printed using a poly (3,4ethylenedioxythiophene)/polystyrene sulfonate (PEDOTPSS) solution. To insulate the final device, a polyimide ink was used to print a thick film, leaving small open windows upon the active sites. Electrical characterization of the final device revealed conductivities in the order of 103 and 102 S.cm-1 for Ag and PEDOT based inks, respectively. Cell adhesion assays performed with PC-12 cells after 96 h of culture, and B16F10 cells after 24 h of culture, demonstrated that the cells adhered on top of the inks and cell differentiation occurred, which indicates Polyimide and PEDOTPSS inks are non-toxic to these cells. The results indicate that PaC, along with its surface-treated variants, is a potentially useful material for fabricating cell-based microdevices.The hepatotoxic effects of sub-lethal concentrations of atrazine (2.5, 25, 250, and 500 μg L-1) on Clarias gariepinus juveniles were assessed for 28 days in a quality-controlled laboratory procedure. The study was designed to determine the effects of atrazine on selected liver function biomarkers alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), albumin (ALB) and total protein (TP), and to analyze the liver tissues of the fish using a quantitative and qualitative histology-based health assessment protocol. The levels of ALB and TP in exposed specimens were observed to decrease with increasing concentrations of atrazine. However, the activities of ALT, AST, and ALP showed significant (p less then 0.05) increase with increasing concentrations of atrazine. Hepatic assessment of the liver tissues revealed marked histopathological alterations, including structural changes (necrotic/apoptotic liver tissue, poor hepatic cord structure, and loss of normal architecture) in 52.
